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Essay Subject: Discusses role of total quality management (TQM) in a global marketplace.... More...

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Paper Abstract: Discusses role of total quality management (TQM) in a global marketplace. Uses Lindare, a home health equipment provider as an example. Definitions of quality (transcendent, product-based, user-based, manufacturing-based, value-based). Goals of a TQM program. Results of interview with a senior Lincare official. Site visit. Evaluation of Lincare's quality program. Paper Introduction: Introduction Quality in general and Total Quality Management (TQM) in particular received much attention in the 1980s and 1990s as American companies try to become more competitive in an increasingly global marketplace. Companies and analysts have heralded quality as America's last best chance to maintain a strong market share, and numerous articles and books have been written on how to implement quality in both manufacturing and service environments. In order to develop quality-based programs, companies must perform quality assessments to determine the components of quality within their industry and market, and then undertake process improvements to enhance the quality both to internal and external customers. This combination of assessment and implementation is known as QAPI (Quality Assessment/Process Improve Text of the Paper: The entire text of the paper is shown below. However, the text is somewhat scrambled. We want to give you as much information as we possibly can about our papers and essays, but we cannot give them away for free. In the text below you will find that while disordered, many of the phrases are essentially intact. From this text you will be able to get a solid sense of the writing style, the concepts addressed, and the sources used in the research paper. Lincare is a nationwide home health equipment provider based inFlorida. The entire company, regardless of whereany one individual is located, could then have access to all of thisinformation. This is a typical problemin companies today: companies can only provide a level of qualitycommensurate with the quality they receive from their own suppliers. 32). On the day of the site visit, one employee was particularly upset thatequipment received earlier from a new supplier was deemed unacceptable.This was the third time a problem had come up with products from thiscompany, and the employee was wondering how much longer Lincare wouldaccept what he considered substandard quality. The transcendentapproach can lead adherents to reject mass production in favor of finecraftsmanship, but more often, those who follow this definition of qualityfind it to be simple and something that cannot be precisely defined, butrecognized only through experience (Farrell, 1994, p. Bonham also reminded everyone that corporate wasevaluating new quality systems which would enable the entire organizationto track products by supplier so that if one facility experienceddifficulties, that could be noted. Problems arediscussed in an open forum, and this group also occasionally identifiesareas that they would like Bonham to pass onto the company's corporateoffices. Once a design or specification has beenestablished, deviation from that design or specification implies areduction in quality. It requires thatvarious departments be seen as "internal" customers as well as consideringthe needs and requirements of external customers (the company's traditionalcustomers). (1993). In addition, the company maintains a high-qualityoperation while keeping its costs low (a combination of ongoing trainingand a reluctance to hire unnecessary employees) and its service level high. TQM is also focused on process improvement, and that is also acritical part of healthcare equipment providers such as Lincare. Healthcare FinancialManagement, pp. Without this commitment, the organizationcannot put the necessary resources into the TQM program, and the programwill be destined for failure. Because TQM encompasses the entire organization, it requires that allemployees be committed to the TQM process. Employee involvement also requires that managers receive training inTQM, as well (Schmidt, 1993, p. According to Bonham, however, this conversation is not merely smalltalk. Instead, Lincare technicians ask probing questions that are openended. Ensuring that healthcare companies have efficient procedures is also one way that the industrycan help dispel the perception that costs are artificially high; thisperception is behind much of the drive for health care reform and calls toregulate the industry more than it is currently regulated (Motwani, Sower &Brashier, 1999, p. 42). This should be reflected in thedevelopment of a mission statement for the company as a whole, andsupported by mission statements for various departments and divisions.This commitment needs to be augmented by providing the necessary resourcesto implement a quality program. However, the local offices areresponsible for implementing those quality procedures, and also developtheir own procedures for quality at the local level. 4 -41). S. Managing Quality. (1998). For thesecompanies, it is important that regular functions (including maintenanceand repair) are performed both efficiently and effectively, andstreamlining the process enables the company to maintain the lowest payrollwhile achieving high levels of customer satisfaction. Garvin, D. The process is essentiallythe same for both small and large organizations, but because largeorganizations are more complex and pose more logistical considerations,problems can arise when a TQM program is implemented. Toleranceof defects becomes very low since each step in the manufacturing or serviceprocess is dependent on the step before with little or no room for delay orerror. New York: Free Press. Thisis because durable goods provide a longer stream of service, so thatquality differences could therefore be treated as differences in quantity(Garvin, 1998, p. Under thetranscendent view, there is an enduring and timeless aspect to quality, anessence that rises above changes in tastes or style. 44). Thistechnique ensures that as many deliveries as possible are captured duringthe routing process, but it requires individuals to be familiar with thelocal traffic patterns and construction zones to be truly effective. Rather than asking, "are you satisfied with the equipment?" Lincarepersonnel will ask, "how is this equipment working for you?" Or, if thetechnician identifies that a problem might be occurring with the use orstorage of the equipment, he or she might say, "we've had some reports ofdifficulty with (area of problem). The employees agreed that this would be difficult sincedemand varies considerably in this industry, but that such a program mightbe workable on a limited basis. But theunderstanding of quality varies from company to company, and even fromdepartment to department within the same company. Eachpiece of equipment is bar coded for identification purposes, and each alsohas a tag with its last date of service and its next date for service.Those items which are in the repair "bin" are also tagged appropriately, asare those which are slated to be returned to suppliers for one reason oranother, and those which have recently been received from suppliers butwhich have not yet been tested. Bonham then asked employees to consider the possibility ofimplementing a JIT system, which is something that corporate had beenconsidering. Employees are also taught to engage in constructive conversation.This is not meant to distract the employees from their primary task(setting up the equipment), but instead ensures that the client or otherpersons understand how the equipment operates, how to maintain it, andother information related to its presence in their home. This means that Lincare shouldestablish close working relationships with its suppliers both in terms ofdelivery and product quality. Differences inquality therefore reflect differences in the quantity of some ingredient orattribute. A quality product is one that provides performance or conformanceat an acceptable price or cost (Garvin, 1998, p. 44. If employee involvement groups areestablished but not responded to, the company will not only not accomplishits quality goals, but it will do damage to the morale of the organizationas a whole. Product-based definitions of quality sometimeslead to the implication that durability can be equated with quality. The area where repairs are completed is also well-organized andstep-by-step instructions for those tasks which are performed mostfrequently posted on the walls. Most felt, however, that JIT should beconsidered further. During these meetings, employees are encouraged to bring upconcerns they might have about any of the areas of operation, and to bringeveryone up to date on specific clients and their needs. Site Visit When visiting the Sevierville facility, one is immediately struck by asense of organization and efficiency. In order to develop quality-based programs, companies mustperform quality assessments to determine the components of quality withintheir industry and market, and then undertake process improvements toenhance the quality both to internal and external customers. Scott, J. This approach is likely to elicit responses that a lessdirected approach would not, and can help the technician identify ways tohelp the client receive more benefit. These resources can include trainingprograms, new equipment, and a shift in the relationship between employeesand managers in order to emphasize increased employee involvement, butwithout commitment from the highest levels of the organization, such ashift is unlikely to occur (Scott, 1998, p. References Bonham, J. Lincare is also concerned with user-based quality. Thiscombination of assessment and implementation is known as QAPI (QualityAssessment/Process Improvement). 77). Typically,videotapes are used to introduce new equipment, and supplemental materialsare provided for reference. It is both absolute and universally recognizable, amark of uncompromising standards and high achievement. Manufacturing-based definitions of quality focus on supply as opposedto demand. 43). The issue of quality was raised here,however, as employees noted that JIT systems depend on receiving qualityparts from suppliers, and any deviation from that results in problemsthroughout the supply chain. The sense of organization extends to the room that is used fortraining. Currently, routing is doneby hand during the afternoon before the deliveries are to take place. Since Lincare is a national organization,some contracts are likely to be handled at the corporate level while otherswill be handled locally (Motwani, Sower & Brashier, 1999, p. Questing for quality. Goods that satisfyeach individual's preference are held to be of high quality for that user.This definition of quality renders the subject ambiguous and subjective.In economics, this definition is used to suggest that quality differencesare reflected by shifts in the demand curve. Within the healthcare sector, TQM requires that Lincare (as anexample), work with its suppliers so that it does not have excess inventoryon hand, but also so that it has an adequate supply of products and sparesto meet the needs of its customers. What is Total Quality Management? However, all suppliers had to beapproved through the central office and no new suppliers had completed theapproval process to date. There is not currently a backup supplier for this equipment, whichBonham acknowledged was a problem. Farrell, R. Quality function deployment.Industrial Engineering, p. W. In service settings, quality is associated withaccuracy and timeliness (Garvin, 1998, p. Goods can be ranked according to the amount of the desiredattribute they possess. Companiesand analysts have heralded quality as America's last best chance tomaintain a strong market share, and numerous articles and books have beenwritten on how to implement quality in both manufacturing and serviceenvironments. 42). Lincare alsorecognizes that the driver might be one of the few social interactions thatoccur in any given day for their clients, so conversation is encouraged. Lincare does not participate in manufacturing, but is concerned withquality and process as they relate to suppliers and vendors. 44). Health Care Management Review,pp. Senior Adviser, Lincare Sevierville. By combining techniques such as just-in-time inventory (JIT)control, quality circles (QC) and other innovative management approaches,the goal is to maximize productivity and bring defects to zero. Repair procedures are performed by Lincaretechnicians when they are capable of doing the job, but may be sent back tothe supplier if necessary. Have you noticed anything like that?"This helps to put the client at ease and reassures them that the problem isnot their fault. Results of the Interview Based on the quality and TQM information outlined above, an interviewwas conducted with Jerry Bonham, senior advisor at the Sevierville,Tennessee Lincare facility. Not only do managers need tounderstand the principles behind TQM, but they also need to rethink theirrelationship with employees. Quality issueslocally include scheduling and delivery, customer satisfaction, and billingpractices (ensuring that accounting procedures are followed so that paymentis received in a timely manner). Some of the quality programs that are in place at Lincare aredictated by the corporate office and are in accordance with contracts thatLincare has with its suppliers. Not only must the company ensure that the productswhich it delivers to customers work correctly each and every time (withlives literally hanging in the balance), but the company must also ensurethat drivers arrive when they are scheduled, that maintenance schedules aremet, and that billing is handled efficiently so that cash flow issufficient to meet the company's needs. It is this aspect of TQM which iscritical to the success of the program. Lincare's usersare interested not only in the proper functioning of the equipment thatthey receive from Lincare, but also in the service that they receive.Clients want to be assured that Lincare will be on-time with deliveries andpick-ups, that the technicians are knowledgeable, and that the insurancebilling results in as little disruption to the client as possible. (2 1). In small organizations, gettingall employees to be involved in the process can be accomplished throughinternal communications and training programs. (1994, October). Lincare is also concernedwith value-based quality since it is important that it manage costs giventhat Medicaid pays a specific rate for Lincare's products and services. Conclusions Lincare's commitment to quality has a direct bearing on the company'slong-term success. When companies address the issue of "quality," it is assumed thateveryone agrees on what quality is for that organization. 32-33. Bonham is responsible for the operation of theSevierville office, and, in that capacity, oversees the quality program atthe office. Any TQM program requires the commitment of the highest levels of theorganization at the outset. Motwani, J., Sower, V. What is Quality? Value-based definitions of quality move the manufacturing-baseddefinition a step further. The company specializes in providing respiratory and relatedequipment to patients in the home, and has a large percentage of Medicaidpatients among its clients. Here, quality is defined in terms of cost andprice. An effective quality management program begins with a commitment fromthe top level of the organization that quality management will become anoverriding philosophy of the organization. The walls are lined with variousreference manuals for the different types of equipment provided by Lincare,and materials from previous training courses are kept in this room forreference. Since drivers are also instructors, this trainingis important in ensuring that the equipment is used properly and to maximumbenefit. A. There are only five Lincare employees who work out of the Seviervillefacility, and most of these are in the field at any one time. BecauseLincare distributes equipment in the healthcare industry, the quality ofthat equipment and its proper functioning is critical not only to customersatisfaction, but indeed, to customer lives. This training encompasses notonly how to operate the equipment, but also how to train other people tooperate the equipment. On rare occasions, a corporate trainer (or atrainer contracted for the purpose) will visit facilities and conduct in-house training. These definitions are concerned with engineering andmanufacturing practices. In this way, Lincare combinesseveral different types of quality, but its commitment remains strong ineach of these areas. H. Maintenance schedules andprocedures are also generated by the corporate office, but are to beimplemented locally. 41). As its name suggests, Total Quality Management is an attempt tomaximize quality within and throughout an organization. 75). According to the transcendent approach, quality can be associated withinnate excellence. As a result, the entire organization is brought into the TQMprocess, from procurement through manufacturing and including accounting. The quality processes associated with theactual equipment, such as maintenance and repair, are defined and mandatedby individuals at the corporate level. New York: Jossey-Bass. TQManager. Instead of imposing their will and ideas onemployees, managers need to listen to the suggestions of their employees onhow and where improvements can be made. Quality standards for new equipment, forexample, are set by the corporate office. Lincare provides a high level of training to its field personnel, someof whom also perform repairs on equipment. Inaddition, Bonham would welcome the use of GPS systems (or systems similarto the Lojack anti-theft system) so that emergency deliveries could bescheduled more efficiently. 73-82. E., & Brashier, L. User-based definitions of quality are based on the idea that eachindividual has a different approach to quality, and what one individualperceives as quality is not what another perceives. (1999, Winter).Implementing TQM in the health care sector. (1998). Product-based quality is precise and measurable. When new employees are hired, senior employees typicallyassume responsibility for training them. Personalinterview. Introduction Quality in general and Total Quality Management (TQM) in particularreceived much attention in the 198 s and 199 s as American companies try tobecome more competitive in an increasingly global marketplace. Effective TQM programs will have a long-termeffect on the way that the organization does business. Schmidt, W. Products which meet the needsof most consumers are considered high quality, while goods which do not arelower quality (Garvin, 1998, p. Five principalapproaches to the issue of quality itself have been defined: transcendent,product-based, user-based, manufacturing-based and value-based (Garvin,1998, pp. There is a videocassette machine in this room, along with amonitor, and a large white board. In order toensure that communication does not break down, Bonham holds weekly staffmeetings. Bonham recognizes that the routing process is not as efficient as itcould be, and Lincare is considering using global positioning systems (GPS)to assist in providing better delivery service. Training can be conducted in a number of different ways. The warehouse area is arrangedneatly with equipment stored in clearly marked and labeled areas. If this paper is not what you are looking for, you can search again: Search for: or Click here to request an essay written just for you.

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